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General NPI Number Information
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NPI Number | 1013326958
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Entity Type | Organization
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Legal Business Name | EYEWORKS
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 1504 HOLLY RD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411
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Country | US
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Telephone | 361-993-5882
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Fax | 361-993-4599
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Provider Business Mailing Address
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Address Line | 1504 HOLLY RD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411
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Country | US
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Telephone | 361-993-5882
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Fax | 361-993-4599
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MRS. AYNN LYNN UPTON
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Credential | OD
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Telephone | 361-993-5882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5299
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3996
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License Number State | TX
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